Summaries of health policy coverage from major news organizations

San Diego County Considering Plan To Outsource Some Mental Health Services

San Diego County officials are proceeding with a plan to contract with private entities to provide mental health services to more than 5,300 county residents, the San Diego Union-Tribune reports. The county currently contracts with outside entities to administer some mental health programs, but the proposal under consideration would privatize some programs that "represent core services," including services for uninsured and homeless residents. Under the proposal, the county would contract with private groups to assume responsibility for:

Administration of five adult outpatient centers that provide medication, individual and group therapy and case management services to about 4,200 people per year;

Administration of an outpatient clinic for youths that treats about 200 people per year;

Adult case management services for about 1,000 people; and

Twenty Psychiatric Emergency Response Teams -- including police and health care providers who deal with situations involving people who may have mental illnesses -- which serve about 1,700 people per year.

The proposal is motivated by a $15 million difference in funding for mental health programs and the cost of administering them. San Diego County has a budget of $205 million for mental health programs, but the state is reducing its contribution by $5.1 million. The state contributes about 60% of the budget for county mental health programs; county and federal funds account for the remainder. The county could save $6 million to $10 million per year by outsourcing the programs, according to the Union-Tribune. County officials are accepting bids for the services and creating requests for proposals to administer the programs. The county plans to implement the changes by Jan. 1, 2005. The county would continue to administer the county psychiatric hospital, mental health services at juvenile hall and an emergency screening unit in Chula Vista.

Reaction

Alfredo Aguirre, acting county mental health director, said, "It's a duty to our community that we don't reduce services," adding, "It's essential that we look to every possible way to cut costs." Bettie Reinhardt, executive director of the San Diego chapter of the National Alliance for the Mentally Ill, questioned the county's timeline for implementing the changes, saying, "When you push things into such a compressed schedule, you end up almost inviting mistakes that may be hard to mend." Brian Polejes, senior field representative for Service Employees International Union Local 535, which represents some county mental health workers, said, "There will be a decline in the service that's offered to a population that desperately needs it." Karen Luton, executive director of the Mental Health Association San Diego County Chapter, said that private entities could provide quality mental health services, adding, "I don't care who provides the services, as long they're providing the right kind of services to the people who need them, when they need them" (Monteagudo, San Diego Union-Tribune, 6/1).

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